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Chapter1

hospitaladmission&patientsafetyUnit1admittingpatientstothehospitalLucas[luk?s]Amy英

[e?m?]

['em?]

Anderson['?nd?sn]Dialogue1

patientregistrationgooverto

朝…走去Booth

[bu?θ]

n.貨攤;公用電話亭counter['ka?nt?]

n.柜臺;對立面;計數(shù)Dialogue1

patientregistrationEmergencyMedicalTreatmentandLaborAct=EMTALA《緊急醫(yī)療護理與勞動法》/rczz/rdxw/405334e4d4703e2e26579288df2b81fc.htmlDialogue1

patientregistrationDialogue2triageTriage傷員驗傷分類BriefassessmentofvictimsClassifyvictimsaccordingtotheseverityoftheinjury,urgencyoftreatment,andplacefortreatmentPrioritizingHighLife-threateningResultinharmifuntreatedIntermediateNonemergencyNon-life-threateningclientneedsLowNeedsthatarenotrelateddirectlytoclient’sillnessorprognosisPrioritizingActualconcerns>potentialconcernsABC:Airway–maintainpatentairway!!!BreathingCirculationMaslow’sHierarchyofneeds:Physiologicalneed→Safety→Loveandbelonging→self-esteem→self-actualizationNursingprocessAssessmentfirstRankAclientwithheartfailurewhohasa4-ibweightgainsinceyesterdayandisexperiencingshortnessofbreathA24-hourpostoperativeclientwhohadawedgeresectionofthelungandhasaclosedchesttubedrainagesystemAclientadmittedtothehospitalforobservationwhohasabsentbowelsounds(腸鳴音消失)Aclientwhoisundergoingsurgeryforahysterectomy(子宮切除術(shù))ofthefollowingday1、2、3、4Ifuareafirstresponderatthesceneofaschoolbusaccident……RankConfusedchildwithbrightredbloodpulsatingfromalegwoundChildwithaclosedheadwoundandmultiplecompoundfracturesofthearmsandlegsChildwithasimplefractureofthearmcomplainingofabdominalpainSobbingchildwithseveralminorlacerationsontheface,arms,andlegs1、2、3、4Uareassignedtocareoffourclients.Inplanningclientrounds,whichcomesfirst?Aclientscheduledforachestx-rayAclientrequiringdailydressingchangesApostoperativeclientpreparingfordischargeAclientreceivingnasaloxygenwhohaddifficultybreathingduringthepreviousshift4AclientwhoisambulatoryAclientscheduledforphysicaltherapyat1pmAclientwithafeverwhoisdiaphoreticandrestlessApostoperativeclientwhohasjustreceivedpainmedication3Triageclients:highestprioritiesAclientcomplainingofmuscleaches,ahead-ache,andmalaiseAclientwhotwistedheranklewhenshefellwhilerollerbladingAclientwithaminorlacerationontheindexfingersustainedwhilecuttinganeggplantAclientwithchestpainwhostatesthathejustatepizzathatwasmadewithaveryspicysauce4Anurseisgivingabedbathtoanassignedclientwhenanursingassistantenterstheclient’sroomandtellsthenursethatanotherassignedclientisinpainandneedspainmedication.Theappropriatenursingactioniswhichofthefollowing?Finishthebedbathandthenadministerthepainmedicationtotheotherclient.Askthenursingassistanttofindoutwhenthelastpainmedicationwasgiventotheclient.AsktheNAtotelltheclientinpainthatmedicationwillbeadministeredassoonasthebedbathiscompleted.Covertheclient,raisethesiderails,telltheclientthatyourwillreturnshortly,andadminister

thepainmedicationtotheotherclient.4Dialogue3directadmissionConversation:patient’sroomSelf-learningUnit2

PatientSafety

HospitalEnvironmentofCareDialogue1FireDrillDrill[dr?l]n.訓練Alarm[?'lɑ?m]n.鬧鐘;警報,警告器Firealarm

火警;[安全]火警警報器Realistic[r??'l?st?k]adj.現(xiàn)實的;現(xiàn)實主義的;逼真的Theoverheadpager揚聲傳呼器JCAHO醫(yī)療機構(gòu)評審聯(lián)合委員會JointCommissiononAccreditationofHealthcareOrganizationsCloseallthedoorsClearthefireexitcorridorsEnsurethattheexitsandtheevacuationroutesarewelllitanddon’thaveobstaclesDuringthedirll…Setprioritiesintheeventofafire:RACERescueclientsinimmediatedangerAlarmContain/Confinethefirebyclosingalldoors關(guān)門限制火勢ExtinguishorevacuateExtinguish[ik'sti?ɡwi?]熄滅Evacuate[?'v?kj?e?t]vt.疏散,撤退Firesafety消防安全Useafireextinguisher滅火器:PASSPullthepin拉出栓Aimatthebaseofthefire對準火焰的根部Squeezethehandle握緊手柄SS:sweepfromsidedosideFiresafety消防安全Hazardousmaterials&wasteRadiationsafety輻射安全Dialogue2FallRiskPatientNameband/armbandConsciousness['k?n??sn?s]n.意識;知覺;覺悟;感覺嗜睡somnolence昏睡stupor昏迷comadelirium

譫妄Bruise[bru?z]Fracture['fr?kt??]骨折Posturalhypotension體位性低血壓Assesstheclient’sriskforfalling.Assigntheclientatriskforfallingtoaroomnearthenurses’station.Alertallpersonneltotheclient’sriskforfalling.Assesstheclientfrequently.Orienttheclienttophysicalsurroundings.Instructtheclienttoseekassistancewhengettingup.Explaintheuseofthecallbellsystem.Usesafetydevicessuchasbedorchairalarmsthatalerthealthcarepersonnel.Keepthebedinthelowpositionwithsiderailsadjustedtoasafeposition(followagencypolicy).Lockallbeds,wheelchairs,andstretchers.Keepclients’personalitemswithintheirreach.Eliminateclutterandobstaclesintheclient’sroom.Provideadequatelighting.Reducebathroomhazards.Maintaintheclient’stoiletingschedulethroughouttheday.MeasurestoPreventFallsAnursehearsaclientcallingoutforhelp,hurriesdownthehallwaytotheclient’sroom,andfindstheclientlyingonthefloor.Thenurseperformsathoroughassessment,assiststheclientb

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